The role of SHMT2 and NDUFA4L2 gene expression and UCA1 levels in Egyptian patients with bladder cancer

Bladder Cancer (BC) has a significant burden, with poor survival rates in advanced cases. This case-controlled study aimed to identify genes having diagnostic and prognostic value. Seventy patients with BC and 70 healthy individuals were included. Real-time PCR was used to quantify the expression of the <i>SHMT2</i> and <i>NDUFA4L2</i> genes, and <i>UCA1</i> levels. Results showed that <i>SHMT2, NDUFA4L2</i>, and <i>UCA1</i> were significantly upregulated in patients compared to the control group (<i>p</i> < 0.001). The area under the receiver operating characteristic curve (ROC) analysis showed that AUC was 0.995 (95% CI = 0.989-1, <i>p</i> < 0.001), 0.994 (95% CI = 0.987-1, <i>p</i> < 0.001) and 0.977 (95% CI = 0.958-0.996, <i>p</i> < 0.001) for <i>UCA1, SHMT2</i>, and <i>NDUFA4L2</i>, respectively with high diagnostic sensitivity and specificity. Additionally, the high expression of <i>SHMT2</i> and the high level of <i>UCA1</i> were correlated with histological grade (<i>p</i> < 0.001and 0.001, respectively) and with CT tumor size (p = 0.005 and 0.001, respectively). In univariate COX regression analysis, <i>SHMT2 and UCA1</i> were poor prognostic (p = 0.003 and 0.001, respectively). Furthermore, in the multivariate analysis, <i>UCA1</i> was independent poor prognostic factor (p =0.037). Thus, <i>SHMT2, NDUFA4L2</i>, and <i>UCA1</i> could be promising diagnostic and prognostic biomarkers and a novel therapeutic target.